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The Commonwealth Fund Connection

A roundup of recent Fund publications, charts, multimedia, and other timely content.




September 17, 2021

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COVID-19


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New International Survey: Older Adults in U.S. Have Faced More Economic Hardship During COVID-19
Nearly one in five older Americans say they used up their savings or lost their main source of income because of the COVID-19 pandemic — a rate several times higher than that found in other high-income countries, a Commonwealth Fund study finds. Drawing from a survey of more than 18,000 adults age 65 and older in the U.S. and 10 other wealthy countries, the report casts a harsh light on the economic vulnerability of U.S. seniors, particularly older Black and Latinx/Hispanic Americans.

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Considerations for Employers Contemplating COVID-19 Vaccine Requirements
With coronavirus cases again surging in many parts of the U.S., President Biden has urged employers to require their employees to get vaccinated for COVID-19. On To the Point, experts from the CUNY Graduate School of Public Health and Health Policy and the Commonwealth Fund highlight strategies for employers considering these requirements, from leveraging trusted, diverse messengers to connecting science with workplace policy.

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Improving Access to Maternity Care Through Telemedicine Coverage
At the outset of the COVID-19 pandemic, Medicaid vastly expanded access to telemedicine, including virtual maternity care. On To the Point, Brenda Gleason and the Commonwealth Fund’s Laurie Zephyrin, M.D., discuss the impact of Medicaid policy changes that three states made: Arizona, North Carolina, and Wyoming. While the reforms appear to have led to improvements in maternity care, it’s uncertain whether these temporary policies will be extended after the public health emergency ends.

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Did COVID-19 Speed Medicare Insolvency?
Without action from Congress, the Medicare Hospital Insurance Trust Fund will run out of funds in 2026. But a key question remains unanswered: What role has COVID-19 played in the program’s current financial troubles? On To the Point, the Commonwealth Fund’s Gretchen Jacobson and Lovisa Gustafsson took a close look at the trust fund and federal Medicare spending to find out if the pandemic has been the catastrophe for Medicare solvency that some experts had feared.

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How a Pandemic-Spurred Change in Medicare Advantage Ratings May Affect Health Plans
A federal judge’s ruling to uphold a change in Medicare Advantage’s star-rating system could have broad implications, reports the University of Pennsylvania Law School’s Allison Hoffman. She explains how the rating change, made by the Centers for Medicare and Medicaid Services in response to the COVID-19 pandemic, could affect plans’ enrollment, compensation, and even participation in the program.

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Innovations from London’s COVID-19 Field Hospital
A recent
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blog post in BMJ Quality & Safety discussed how “bedside learning coordinators” were used to promote medication safety at the Nightingale, a field hospital opened by England’s National Health Service during the first wave of the COVID-19 pandemic. Read our 2020
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Q&A with James Mountford, M.D., who helped set up and run the Nightingale with Gregg Meyer, M.D., to learn how together they brainstormed strategies for staffing and running field hospitals.


Other Recent Publications


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Texas Engineers a Way to Block Most Abortions
A new Texas law banning most abortions circumvents the U.S. Constitution and endangers the health of pregnant people, say health law experts Katie Keith and Timothy S. Jost. The unprecedented law, S.B. 8, authorizes private individuals to bring suit against anyone who performs or knowingly “aids and abets” an abortion after six weeks of pregnancy. Read their post on To the Point to find out what might happen next in the fight to block the legislation and preserve abortion rights.

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New Analysis: Uninsured Population Would Fall Under Proposed Reforms
Congress is considering plans to make permanent the American Rescue Plan Act’s temporary boost in subsidies for marketplace health plans and to fill what’s known as the Medicaid coverage gap. Together, these two reforms would sharply reduce the number of Americans under 65 who lack coverage, according to an analysis from the Urban Institute and the Commonwealth Fund. Black Americans would see the biggest coverage gains.

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Special Marketplace Enrollment Period Could Allow More Low-Income People to Get Coverage
The Biden administration is considering a special enrollment period (SEP) to make it easier for people with low income to enroll in marketplace coverage year-round. Georgetown University’s Katie Keith explains how the proposed SEP could extend affordable coverage to an estimated 1.3 million people, many of whom are young adults and people of color. Under the American Rescue Plan Act, those eligible for the new SEP could enroll in free or nearly free plans.

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Protecting Consumers from Bad Insurance
Although the American Rescue Plan Act has made marketplace coverage more affordable, some insurers continue to push limited, low-premium plans that at first glance look like comprehensive coverage but actually leave consumers virtually uninsured. Georgetown University’s Dania Palanker and Kevin Lucia says enrollment in these plans has been difficult to track, partly because they are often sold through multistate entities that are good at evading regulators.

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Is the ACA’s Preventive Care Mandate Constitutional?
Does the Affordable Care Act’s requirement that most health plans cover preventive services for free pass constitutional muster? Legal expert Timothy S. Jost examines the mandate, its impact, and the validity of lawsuits challenging it. Opponents of the provision claim it’s unconstitutional, in large part because they object to coverage of contraceptives and preexposure prophylaxis on religious or other grounds. According to Jost, if these challenges succeed, “all preventive services coverage, including those for COVID, are at risk.”

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